| NPI | 1447696745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X Radiology Radiation Oncology (Licence: NV 23640) |
| Additional Taxonomies | 2085R0001X Radiology Radiation Oncology (Licence: NM MD2023-0081) |
| 2085R0001X Radiology Radiation Oncology (Licence: CA A170315) | |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2023-08-11 |